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Silver Warriors Pilot – Positive Life NSW
Positive Life NSW is a non-profit peer-led community-based agency. They work to promote a positive image of people living with and affected by HIV with the aim of eliminating prejudice, isolation, stigma and discrimination. PLNSW provides information and targeted referrals, and advocates to change systems and practices that discriminate against people living with HIV (PLHIV), our friends, family and carers in NSW.
PLNSW were incorporated on 21 July 1989 as People Living With HIV/AIDS (PLWHA) NSW.
In 2018 Positive Life NSW received a Community Grant from ViiV Healthcare Australia to develop a program model to educate and support ageing PLHUIV who are unsure about how to access and navigate services.
By 2020, there will be approximately 4,800 to 5,000 Australian PLHIV aged 65 years + who are potentially eligible for My Aged Care home support, respite and residential Aged Care services (Wilson, Kirby Inst. 2011). A further 7,650 PLHIV will be eligible over the next 10 years (aged 55-64 Years) (Wilson, Kirby Inst. 2011). The majority of these ageing PLHIV live in NSW (41%) Victoria (24%) and Queensland (19%), with smaller populations in Western Australia, South Australia, the Northern Territory and Tasmania (Wilson, Kirby Inst. 2011). Most PLHIV reside in the major capital cities (approximately 75% depending upon jurisdiction), live alone (58%) (Petoumenos, Kirby Inst. 2019) and experience comorbidity (both physical and mental) (Petoumenos, Kirby Inst. 2019). These factors often limit ability to perform activities of daily living. In yet to be published Australian research (Petoumenos, Kirby Institute, 2019), 13% of HIV-positive MSM aged 55 years and older report severe physical functional limitation. A further 26% report moderate to severe physical functional limitation. PLHIV with functional limitations will require home support services through My Aged Care or NDIS to remain living independently within the community.
Older PLHIV have told Positive Life that they want a person-centred service approach where information is tailored to their needs. Currently, there is no specialist service which supports the growing number of ageing PLHIV who need help to navigate a complicated health, Aged Care and disability service system. Many PLHIV report anxiety about engaging with aged care and disability services in older age. They also report fear of having to prematurely relocate into residential aged care facilities that may discriminate against them because of their HIV status, sexual orientation and lifestyle choices because they can no longer manage living independently. They question how they will source Aged Care service information and make informed decisions about care.
In an era when government and non-government information is primarily accessed online, many find websites difficult to navigate, confusing and hard to understand. Some older PLHIV don’t have access to the internet or are unable to navigate electronic information and mobile devices. This places them at a significant disadvantage. While BGF and LHD HIV Outreach Teams in the inner Sydney area already provide a comprehensive case management/care coordination service, their staff are not resourced to provide expert information on Aged Care. Silver Warriors would work in with these services to address PLHIV needs and fears and bridge the information and referral gap to connect PLHIV to existing health and support services as well as aged care and disability services.
Silver Warriors will:
- Educate older PLHIV about their aged care, disability and healthcare service options;
- Support older PLHIV to remain engaged in HIV and other healthcare and to maintain adherence to HIV and other prescribed treatment; and
- Address stigma by enabling eligible PLHIV to utilise government aged care and disability services and non-government services to ensure services are responsive to need.
Silver Warriors responds to the needs and anxieties of older PLHIV and PLHIV with complex care needs by providing a supportive and enabling environment to conduct:
- Assessment - Ageing PLHIV will be assessed to determine their individual Aged Care, disability, health care and other support service needs;
- Information provision - Aged Care, disability and health care service information will be provided according to assessed need. Staff will ensure that PLHIV have all necessary information and support to enable them to make an informed decision about their service needs;
- Service linkage - PLHIV will be linked to service(s) that match their needs. This includes referral to Aged Care services, disability services and to HIV treatment and care services, mental health professionals and other support services such as housing, AOD services, re-employment, case management (BGF and HIV care coordination/case management services) and social supports, as required;
- Support with assessments and applications - PLHIV will be linked to and supported with Aged Care Assessment Team (ACAT) assessments including help to identify and report on their needs to ACAT assessors. They will also receive support to apply for Aged Care and/or NDIS service packages;
- Client follow-up – participant follow-up will assess whether service delivery has been satisfactorily provided and needs met;
- Service barriers – will be identified, documented and address through targeted training initiatives.